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Metabolic myopathy presenting with polyarteritis nodosa: a case report
Sahana Vishwanath1, Mishal Abdullah, Amro Elbalkhi
1Department of Medicine, SUNY at Buffalo School of Medicine, 100 High Street, Buffalo, NY 14203, USA. jambrus@buffalo.edu.
Journal of Medical Case Reports
|July 2, 2011
Summary
This case report details a rare metabolic myopathy presenting after polyarteritis nodosa treatment. Early diagnosis and combined therapy improved patient outcomes, highlighting the importance of considering metabolic myopathies in unexplained exercise intolerance.
Area of Science:
- Neurology
- Metabolic Disorders
- Rheumatology
Background:
- Presents a unique case of metabolic myopathy diagnosed after treatment failure for polyarteritis nodosa.
- Highlights the potential for metabolic myopathies to manifest later in life.
- Explores a possible link between metabolic myopathy and systemic vasculitis.
Purpose of the Study:
- To describe a patient with an unusual metabolic myopathy.
- To raise awareness of metabolic myopathies presenting in older adults.
- To discuss the management of complex metabolic myopathies.
Main Methods:
- A 78-year-old woman with fatigue and weakness underwent biochemical muscle studies.
- Muscle biopsy confirmed medium-sized artery vasculitis consistent with polyarteritis nodosa.
- Enzyme activities for cytochrome C oxidase, acid maltase, and neutral maltase were assessed.
Main Results:
- Biochemical studies revealed diminished cytochrome C oxidase and elevated acid and neutral maltase activities.
- Treatment for polyarteritis nodosa yielded minimal improvement.
- A specialized diet and supplements led to significant clinical improvement.
Conclusions:
- The patient's symptoms were attributed to a complex metabolic myopathy affecting mitochondrial and glycogen pathways.
- Successful management required addressing both polyarteritis nodosa and metabolic myopathy.
- Metabolic myopathies are common and should be suspected in patients with exercise intolerance.
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